Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction

Cardiology Section, Veterans Affairs Medical Center, Tuscon, Arizona 85723.

OBJECTIVES. The purpose of this study was to determine whether left atrial size and ejection fraction are related to left ventricular filling pressures in patients with coronary artery disease. BACKGROUND. In patients with coronary artery disease, left ventricular filling pressures can be estimated by using Doppler mitral and pulmonary venous flow velocity variables. However, because these flow velocities are age dependent, additional variables that indicate elevated left ventricular filling pressures are needed to increase diagnostic accuracy. METHODS. Echocardiographic left atrial and Doppler mitral and pulmonary venous flow velocity variables were correlated with left ventricular filling pressures in 70 patients undergoing cardiac catheterization. RESULTS. Left atrial size and volumes were larger and left atrial ejection fractions were lower in patients with elevated left ventricular filling pressures. Mean pulmonary wedge pressure was related to mitral E/A wave velocity ratio (r = 0.72), left atrial minimal volume (r = 0.70), left atrial ejection fraction (r = -0.66) and atrial filling fraction (r = -0.66). Left ventricular end-diastolic and A wave pressures were related to the difference in pulmonary venous and mitral A wave duration (both r = 0.77). By stepwise multilinear regression analysis, the ratio of mitral E to A wave velocity was the most important determinant of pulmonary wedge (r = 0.63) and left ventricular pre-A wave (r = 0.75) pressures, whereas the difference in pulmonary venous and mitral A wave duration was the most important variable for both left ventricular A wave (r = 0.75) and left ventricular end-diastolic (r = 0.80) pressures. The sensitivity of a left atrial minimal volume > 40 cm3 for identifying a mean pulmonary wedge pressure > 12 mm Hg was 82%, with a specificity of 98%. CONCLUSIONS. Left atrial size, left atrial ejection fraction and the difference between mitral and pulmonary venous flow duration at atrial contraction are independent determinants of left ventricular filling pressures in patients with coronary artery disease. The additive value of left atrial size and Doppler variables in estimating filling pressures and the possibility that left atrial size may be less age dependent than other mitral and pulmonary venous flow velocity variables merit further investigation.

This article has been cited by other articles:

				Q. Ciampi, B. Petruzziello, M. D. Porta, S. Caputo, V. Manganiello, C. Astarita, and B. Villari Effect of intraventricular dyssynchrony on diastolic function and exercise tolerance in patients with heart failure Eur J Echocardiogr, December 1, 2009; 10(8): 907 - 913. [Abstract] [Full Text] [PDF]

				J. Stritzke, M. R. P. Markus, S. Duderstadt, W. Lieb, A. Luchner, A. Doring, U. Keil, H.-W. Hense, H. Schunkert, and for the MONICA/KORA Investigators The Aging Process of the Heart: Obesity Is the Main Risk Factor for Left Atrial Enlargement During Aging The MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) Study. J. Am. Coll. Cardiol., November 17, 2009; 54(21): 1982 - 1989. [Abstract] [Full Text] [PDF]

				S. G. Teo, H. Yang, P. Chai, and T. C. Yeo Impact of left ventricular diastolic dysfunction on left atrial volume and function: a volumetric analysis Eur J Echocardiogr, October 13, 2009; (2009) jep153v1. [Abstract] [Full Text] [PDF]

				A. Rossi, P. L. Temporelli, M. Quintana, F. L. Dini, S. Ghio, G. S. Hillis, A. L. Klein, N. Ajmone Marsan, D. L. Prior, C. M. Yu, et al. Independent relationship of left atrial size and mortality in patients with heart failure: an individual patient meta-analysis of longitudinal data (MeRGE Heart Failure) Eur J Heart Fail, October 1, 2009; 11(10): 929 - 936. [Abstract] [Full Text] [PDF]

				M. Stahlberg, M. Damgaard, P. Norsk, A. Gabrielsen, A. Sahlen, C. Linde, and F. Braunschweig Cardiac output response to changes of the atrioventricular delay in different body positions and during exercise in patients receiving cardiac resynchronization therapy Europace, September 1, 2009; 11(9): 1160 - 1167. [Abstract] [Full Text] [PDF]

				T K Lim, G Dwivedi, S Hayat, S Majumdar, and R Senior Independent value of left atrial volume index for the prediction of mortality in patients with suspected heart failure referred from the community Heart, July 15, 2009; 95(14): 1172 - 1178. [Abstract] [Full Text] [PDF]

				I A Paraskevaidis, F Panou, C Papadopoulos, D Farmakis, J Parissis, I Ikonomidis, A Rigopoulos, E K Iliodromitis, and D Th Kremastinos Evaluation of left atrial longitudinal function in patients with hypertrophic cardiomyopathy: a tissue Doppler imaging and two-dimensional strain study Heart, March 15, 2009; 95(6): 483 - 489. [Abstract] [Full Text] [PDF]

				J-W Ha, D Choi, S Park, E-Y Choi, C-Y Shim, J-M Kim, J-A Ahn, S-W Lee, J K Oh, and N Chung Left ventricular diastolic functional reserve during exercise in patients with impaired myocardial relaxation at rest Heart, March 1, 2009; 95(5): 399 - 404. [Abstract] [Full Text] [PDF]

				K. Fatema, M. E. Barnes, K. R. Bailey, W. P. Abhayaratna, S. Cha, J. B. Seward, and T. S.M. Tsang Minimum vs. maximum left atrial volume for prediction of first atrial fibrillation or flutter in an elderly cohort: a prospective study Eur J Echocardiogr, March 1, 2009; 10(2): 282 - 286. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, C. P. Appleton, T. C. Gillebert, P. N. Marino, J. K. Oh, O. A. Smiseth, A. D. Waggoner, F. A. Flachskampf, P. A. Pellikka, and A. Evangelisa Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography Eur J Echocardiogr, March 1, 2009; 10(2): 165 - 193. [Full Text] [PDF]

				A. Meris, M. Amigoni, H. Uno, J. J. Thune, A. Verma, L. Kober, M. Bourgoun, J. J. McMurray, E. J. Velazquez, A. P. Maggioni, et al. Left atrial remodelling in patients with myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: the VALIANT Echo Study Eur. Heart J., January 1, 2009; 30(1): 56 - 65. [Abstract] [Full Text] [PDF]

				S.-H. Lee, S.-B. Yoon, J.-R. Cho, S. Choi, J.-H. Jung, and N. Lee The Effects of Different {beta}-Blockers on Left-Ventricular Volume and Function After Primary Coronary Stenting in Acute Myocardial Infarction Angiology, January 1, 2009; 59(6): 676 - 681. [Abstract] [PDF]

				A. Boccanelli, G. F. Mureddu, G. Cacciatore, F. Clemenza, A. Di Lenarda, A. Gavazzi, M. Porcu, R. Latini, D. Lucci, A. P. Maggioni, et al. Anti-remodelling effect of canrenone in patients with mild chronic heart failure (AREA IN-CHF study): final results Eur J Heart Fail, January 1, 2009; 11(1): 68 - 76. [Abstract] [Full Text] [PDF]

				S. Andrietti, A.-J. Kruse, S. C. A. M. Bekkers, S. Sep, M. Spaanderman, and L. L. H. Peeters Cardiac Adaptation to Pregnancy in Women with a History of Preeclampsia and a Subnormal Plasma Volume Reproductive Sciences, December 1, 2008; 15(10): 1059 - 1065. [Abstract] [PDF]

				A. Biolo, S. Ramamurthy, L. H. Connors, C. J. O'Hara, H. K. Meier-Ewert, P. T. Soo Hoo, D. B. Sawyer, D. S. Seldin, and F. Sam Matrix Metalloproteinases and Their Tissue Inhibitors in Cardiac Amyloidosis: Relationship to Structural, Functional Myocardial Changes and to Light Chain Amyloid Deposition Circ Heart Fail, November 1, 2008; 1(4): 249 - 257. [Abstract] [Full Text] [PDF]

				C. Jarnert, A. Melcher, K. Caidahl, H. Persson, L. Ryden, and M. J. Eriksson Left atrial velocity vector imaging for the detection and quantification of left ventricular diastolic function in type 2 diabetes Eur J Heart Fail, November 1, 2008; 10(11): 1080 - 1087. [Abstract] [Full Text] [PDF]

				T. Ishizu, Y. Seo, S. Kawano, S. Watanabe, T. Ishimitsu, and K. Aonuma Stratification of impaired relaxation filling patterns by passive leg lifting in patients with preserved left ventricular ejection fraction Eur J Heart Fail, November 1, 2008; 10(11): 1094 - 1101. [Abstract] [Full Text] [PDF]

				M. Y. Chan, H.-B. Wong, H.-Y. Ong, and T.-C. Yeo Prognostic value of left atrial size in chronic kidney disease Eur J Echocardiogr, November 1, 2008; 9(6): 736 - 740. [Abstract] [Full Text] [PDF]

				K. Fatema, K. R. Bailey, G. W. Petty, I. Meissner, M. Osranek, A. A. Alsaileek, B. K. Khandheria, T. S. Tsang, and J. B. Seward Increased Left Atrial Volume Index: Potent Biomarker for First-Ever Ischemic Stroke Mayo Clin. Proc., October 1, 2008; 83(10): 1107 - 1114. [Abstract] [Full Text] [PDF]

				S. Bangalore and F. A. Chaudhry Reply. J. Am. Coll. Cardiol., January 29, 2008; 51(4): 515 - 516. [Full Text] [PDF]

				H. Rakowski and S. Carasso Quantifying Diastolic Function in Hypertrophic Cardiomyopathy: The Ongoing Search for the Holy Grail Circulation, December 4, 2007; 116(23): 2662 - 2665. [Full Text] [PDF]

				A. Rossi, M. Cicoira, S. Bonapace, G. Golia, L. Zanolla, L. Franceschini, and C. Vassanelli Left atrial volume provides independent and incremental information compared with exercise tolerance parameters in patients with heart failure and left ventricular systolic dysfunction Heart, November 1, 2007; 93(11): 1420 - 1425. [Abstract] [Full Text] [PDF]

				L. Hatle How to diagnose diastolic heart failure a consensus statement Eur. Heart J., October 2, 2007; 28(20): 2421 - 2423. [Full Text] [PDF]

				S. Bangalore, S.-S. Yao, and F. A. Chaudhry Role of Left Atrial Size in Risk Stratification and Prognosis of Patients Undergoing Stress Echocardiography J. Am. Coll. Cardiol., September 25, 2007; 50(13): 1254 - 1262. [Abstract] [Full Text] [PDF]

				A. Bayes-Genis, R. Vazquez, T. Puig, C. Fernandez-Palomeque, J. Fabregat, A. Bardaji, D. Pascual-Figal, J. Ordonez-Llanos, M. Valdes, A. Gabarrus, et al. Left atrial enlargement and NT-proBNP as predictors of sudden cardiac death in patients with heart failure Eur J Heart Fail, August 1, 2007; 9(8): 802 - 807. [Abstract] [Full Text] [PDF]

				M. Alam, N. Witt, R. Nordlander, and B. A. Samad Detection of abnormal left ventricular function by Doppler tissue imaging in patients with a first myocardial infarction and showing normal function assessed by conventional echocardiography Eur J Echocardiogr, January 1, 2007; 8(1): 37 - 41. [Abstract] [Full Text] [PDF]

				M. Osranek, K. Fatema, F. Qaddoura, A. Al-Saileek, M. E. Barnes, K. R. Bailey, B. J. Gersh, T. S.M. Tsang, K. J. Zehr, and J. B. Seward Left Atrial Volume Predicts the Risk of Atrial Fibrillation After Cardiac Surgery: A Prospective Study J. Am. Coll. Cardiol., August 15, 2006; 48(4): 779 - 786. [Abstract] [Full Text] [PDF]

				J. E. Moller, P. A. Pellikka, G. S. Hillis, and J. K. Oh Prognostic Importance of Diastolic Function and Filling Pressure in Patients With Acute Myocardial Infarction Circulation, August 1, 2006; 114(5): 438 - 444. [Full Text] [PDF]

				W. P. Abhayaratna, J. B. Seward, C. P. Appleton, P. S. Douglas, J. K. Oh, A. J. Tajik, and T. S.M. Tsang Left Atrial Size: Physiologic Determinants and Clinical Applications J. Am. Coll. Cardiol., June 20, 2006; 47(12): 2357 - 2363. [Abstract] [Full Text] [PDF]

				A. A. Alsaileek, M. Osranek, K. Fatema, R. B. McCully, T. S. Tsang, and J. B. Seward Predictive Value of Normal Left Atrial Volume in Stress Echocardiography J. Am. Coll. Cardiol., March 7, 2006; 47(5): 1024 - 1028. [Abstract] [Full Text] [PDF]

				O. Kamp Advanced Systolic and Diastolic Function: Beyond the E-and A-wave Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2006; 10(1): 63 - 65. [Abstract] [PDF]

				J. Poelaert The Failing Heart Under Stress: Echocardiography is an Essential Monitoring Tool in the Intensive Care Unit Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2006; 10(1): 111 - 115. [Abstract] [PDF]

				R. M. Lang, M. Bierig, R. B. Devereux, F. A. Flachskampf, E. Foster, P. A. Pellikka, M. H. Picard, M. J. Roman, J. Seward, J. Shanewise, et al. Recommendations for chamber quantification Eur J Echocardiogr, March 1, 2006; 7(2): 79 - 108. [Abstract] [Full Text] [PDF]

				J. O. Hunderi, C. R. Thompson, and O. A. Smiseth Deceleration time of systolic pulmonary venous flow: a new clinical marker of left atrial pressure and compliance J Appl Physiol, February 1, 2006; 100(2): 685 - 689. [Abstract] [Full Text] [PDF]

				G. S. Pressman, M. A. Arias, F. Garcia-Rio, A. Alonso-Fernandez, O. Mediano, J. Villamor, and I. Martinez Letter Regarding Article by Arias et al, "Obstructive Sleep Apnea Syndrome Affects Left Ventricular Diastolic Function: Effects of Nasal Continuous Positive Airway Pressure in Men" * Response Circulation, January 3, 2006; 113(1): e11 - e11. [Full Text] [PDF]

				J.-W. Ha, J.-A. Ahn, J.-Y. Moon, H.-S. Suh, S.-M. Kang, S.-J. Rim, Y. Jang, N. Chung, W.-H. Shim, and S.-Y. Cho Triphasic mitral inflow velocity with mid-diastolic flow: The presence of mid-diastolic mitral annular velocity indicates advanced diastolic dysfunction Eur J Echocardiogr, January 1, 2006; 7(1): 16 - 21. [Abstract] [Full Text] [PDF]

				M. Osranek, F. Bursi, K. R. Bailey, B. R. Grossardt, R. D. Brown Jr, S. L. Kopecky, T. S. Tsang, and J. B. Seward Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up Eur. Heart J., December 1, 2005; 26(23): 2556 - 2561. [Abstract] [Full Text] [PDF]

				C. Wallentin Guron, O. Bech-Hanssen, R. Wikh, A. Rosengren, M. Hartford, and K. Caidahl The E/e filling index and right ventricular pressure in relation to applied international Doppler recommendations of left ventricular filling assessment Eur J Echocardiogr, December 1, 2005; 6(6): 419 - 428. [Abstract] [Full Text] [PDF]

				J.-W. Ha, J.-R. Cho, J.-M. Kim, J.-A. Ahn, E.-Y. Choi, S.-M. Kang, S.-J. Rim, and N. Chung Tissue Doppler-Derived Indices Predict Exercise Capacity in Patients With Apical Hypertrophic Cardiomyopathy Chest, November 1, 2005; 128(5): 3428 - 3433. [Abstract] [Full Text] [PDF]

				J. Dernellis and M. Panaretou Effects of Levosimendan on Restrictive Left Ventricular Filling in Severe Heart Failure: A Combined Hemodynamic and Doppler Echocardiographic Study Chest, October 1, 2005; 128(4): 2633 - 2639. [Abstract] [Full Text] [PDF]

				A. Diwan, M. McCulloch, G. M. Lawrie, M. J. Reardon, and S. F. Nagueh Doppler Estimation of Left Ventricular Filling Pressures in Patients With Mitral Valve Disease Circulation, June 21, 2005; 111(24): 3281 - 3289. [Abstract] [Full Text] [PDF]

				P. M Mottram and T. H Marwick Assessment of diastolic function: what the general cardiologist needs to know Heart, May 1, 2005; 91(5): 681 - 695. [Full Text] [PDF]

				R. Senior and H. Ashrafian Screening for isolated diastolic dysfunction - a bridge too far? Eur J Echocardiogr, March 1, 2005; 6(2): 79 - 82. [Full Text] [PDF]

				F. Bukachi, A. Waldenstrom, S. Morner, P. Lindqvist, M.Y. Henein, and E. Kazzam Pulmonary venous flow reversal and its relationship to atrial mechanical function in normal subjects - Umea General Population Heart Study Eur J Echocardiogr, March 1, 2005; 6(2): 107 - 116. [Abstract] [Full Text] [PDF]

				J. I. Poelaert and G. Schupfer Hemodynamic Monitoring Utilizing Transesophageal Echocardiography: The Relationships Among Pressure, Flow, and Function Chest, January 1, 2005; 127(1): 379 - 390. [Full Text] [PDF]

				J. Dernellis and M. Panaretou Assessment of left atrial input impedance in normal subjects and in hypertensive patients Eur J Heart Fail, January 1, 2005; 7(1): 63 - 68. [Abstract] [Full Text] [PDF]

				A. W. Bowman and S. J. Kovacs Prediction and assessment of the time-varying effective pulmonary vein area via cardiac MRI and Doppler echocardiography Am J Physiol Heart Circ Physiol, January 1, 2005; 288(1): H280 - H286. [Abstract] [Full Text] [PDF]

				R. Beinart, V. Boyko, E. Schwammenthal, R. Kuperstein, A. Sagie, H. Hod, S. Matetzky, S. Behar, M. Eldar, and M. S. Feinberg Long-term prognostic significance of left atrial volume in acute myocardial infarction J. Am. Coll. Cardiol., July 21, 2004; 44(2): 327 - 334. [Abstract] [Full Text] [PDF]

				H. Dokainish, W. A. Zoghbi, N. M. Lakkis, F. Al-Bakshy, M. Dhir, M. A. Quinones, and S. F. Nagueh Optimal Noninvasive Assessment of Left Ventricular Filling Pressures: A Comparison of Tissue Doppler Echocardiography and B-Type Natriuretic Peptide in Patients With Pulmonary Artery Catheters Circulation, May 25, 2004; 109(20): 2432 - 2439. [Abstract] [Full Text] [PDF]

				T. J. Bunch, K. Chandrasekaran, B. J. Gersh, S. C. Hammill, D. O. Hodge, A. H. Khan, D. L. Packer, and P. A. Pellikka The prognostic significance of exercise-induced atrial arrhythmias J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1236 - 1240. [Abstract] [Full Text] [PDF]

				C.-C. Wu, Y.-P. Lin, W.-C. Yu, W.-S. Lee, T.-L. Hsu, P. Y.-A. Ding, and C.-H. Chen The assessment of fluid status in haemodialysis patients: usefulness of the Doppler echocardiographic parameters Nephrol. Dial. Transplant., March 1, 2004; 19(3): 644 - 651. [Abstract] [Full Text] [PDF]

				J Kawai, K Tanabe, C.-L Wang, T Tani, T Yagi, H Shiotani, and S Morioka Comparison of left atrial size by freehand scanning three-dimensional echocardiography and two-dimensional echocardiography Eur J Echocardiogr, January 1, 2004; 5(1): 18 - 24. [Abstract] [Full Text] [PDF]

				S R Ommen and R A Nishimura A clinical approach to the assessment of left ventricular diastolic function by Doppler echocardiography: update 2003 Heart, November 1, 2003; 89(90003): iii18 - 23. [Full Text] [PDF]

				L. Spinelli, M. Petretta, G. Verderame, G. Carbone, A. A. Venetucci, A. Petretta, W. Acampa, D. Bonaduce, A. Colao, and A. Cuocolo Left Ventricular Diastolic Function and Cardiac Performance during Exercise in Patients with Acromegaly J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4105 - 4109. [Abstract] [Full Text] [PDF]

				J. E. Moller, G. S. Hillis, J. K. Oh, J. B. Seward, G. S. Reeder, R. S. Wright, S. W. Park, K. R. Bailey, and P. A. Pellikka Left Atrial Volume: A Powerful Predictor of Survival After Acute Myocardial Infarction Circulation, May 6, 2003; 107(17): 2207 - 2212. [Abstract] [Full Text] [PDF]

				T. Tabata, J. D. Thomas, and A. L. Klein Pulmonary venous flow by doppler echocardiography: revisited 12 years later J. Am. Coll. Cardiol., April 16, 2003; 41(8): 1243 - 1250. [Abstract] [Full Text] [PDF]

				A. L. Valentine, J. Pope, and T. Read Evaluation of Left Atrial Size and Pressure as It Relates to Left Ventricle Diastolic Measurements in Patients With Left Ventricle Hypertrophy Journal of Diagnostic Medical Sonography, March 1, 2003; 19(2): 73 - 79. [Abstract] [PDF]

				T. S. M. Tsang, B. J. Gersh, C. P. Appleton, A. J. Tajik, M. E. Barnes, K. R. Bailey, J. K. Oh, C. Leibson, S. C. Montgomery, and J. B. Seward Left ventricular diastolic dysfunction as a predictor of the first diagnosed nonvalvular atrial fibrillation in 840 elderly men and women J. Am. Coll. Cardiol., November 6, 2002; 40(9): 1636 - 1644. [Abstract] [Full Text] [PDF]

				A. Rossi, M. Cicoira, L. Zanolla, R. Sandrini, G. Golia, P. Zardini, and M. Enriquez-Sarano Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1425 - 1430. [Abstract] [Full Text] [PDF]

				M. Cicoira, L. Zanolla, A. Rossi, G. Golia, L. Franceschini, G. Brighetti, P. Marino, and P. Zardini Long-term, dose-dependent effects of spironolactone on left ventricular function and exercise tolerance in patients with chronic heart failure J. Am. Coll. Cardiol., July 17, 2002; 40(2): 304 - 310. [Abstract] [Full Text] [PDF]

				G. A. Whalley, R. N. Doughty, G. D. Gamble, S. P. Wright, H. J. Walsh, S. A. Muncaster, and N. Sharpe Pseudonormal mitral filling pattern predicts hospital re-admission in patients with congestive heart failure J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1787 - 1795. [Abstract] [Full Text] [PDF]

				R. Lattik, P. Couture, A. Y. Denault, M. Carrier, F. Harel, J. Taillefer, and J.-C. Tardif Mitral Doppler Indices Are Superior to Two-Dimensional Echocardiographic and Hemodynamic Variables in Predicting Responsiveness of Cardiac Output to a Rapid Intravenous Infusion of Colloid Anesth. Analg., May 1, 2002; 94(5): 1092 - 1099. [Abstract] [Full Text] [PDF]

				Y Matsumura, P M Elliott, M S Virdee, P Sorajja, Y Doi, and W J McKenna Left ventricular diastolic function assessed using Doppler tissue imaging in patients with hypertrophic cardiomyopathy: relation to symptoms and exercise capacity Heart, March 1, 2002; 87(3): 247 - 251. [Abstract] [Full Text] [PDF]

				S.-J. Dong, P. S. Hees, C. O. Siu, J. L. Weiss, and E. P. Shapiro MRI assessment of LV relaxation by untwisting rate: a new isovolumic phase measure of tau Am J Physiol Heart Circ Physiol, November 1, 2001; 281(5): H2002 - H2009. [Abstract] [Full Text] [PDF]

				T. D. Kinnaird, C. R. Thompson, and B. I. Munt The deceleration time of pulmonary venous diastolic flow is more accurate than the pulmonary artery occlusion pressure in predicting left atrial pressure J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2025 - 2030. [Abstract] [Full Text] [PDF]

				H. Valensise, G. P. Novelli, B. Vasapollo, G. Di Ruzza, M. E. Romanini, M. Marchei, G. Larciprete, D. Manfellotto, C. Romanini, and A. Galante Maternal Diastolic Dysfunction and Left Ventricular Geometry in Gestational Hypertension Hypertension, May 1, 2001; 37(5): 1209 - 1215. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, S. J. Stetson, N. M. Lakkis, D. Killip, A. Perez-Verdia, M. L. Entman, W. H. Spencer III, and G. Torre-Amione Decreased Expression of Tumor Necrosis Factor-{{alpha}} and Regression of Hypertrophy After Nonsurgical Septal Reduction Therapy for Patients With Hypertrophic Obstructive Cardiomyopathy Circulation, April 10, 2001; 103(14): 1844 - 1850. [Abstract] [Full Text] [PDF]

				E. Traversi, F. Cobelli, and M. Pozzoli Doppler echocardiography reliably predicts pulmonary artery wedge pressure in patients with chronic heart failure even when atrial fibrillation is present Eur J Heart Fail, March 1, 2001; 3(2): 173 - 181. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, H. Sun, H. A. Kopelen, K. J. Middleton, and D. S. Khoury Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler J. Am. Coll. Cardiol., January 1, 2001; 37(1): 278 - 285. [Abstract] [Full Text] [PDF]

				P. Poirier, P. Bogaty, C. Garneau, L. Marois, and J.-G. Dumesnil Diastolic Dysfunction in Normotensive Men with Well-Controlled Type 2 Diabetes: Importance of maneuvers in echocardiographic screening for preclinical diabetic cardiomyopathy Diabetes Care, January 1, 2001; 24(1): 5 - 10. [Abstract] [Full Text]

				S. Martins, R. M. Soares, L. Branco, S. Salomao, and A. M. Antunes Non-invasive monitoring of pulmonary capillary wedge pressure in heart failure Eur J Heart Fail, January 1, 2001; 3(1): 41 - 46. [Abstract] [Full Text] [PDF]

				J. J. M. H. Strik, A. Honig, R. Lousberg, A. H. P. Lousberg, E. C. Cheriex, H. G. Tuynman-Qua, P. M. J. C. Kuijpers, H. J. J. Wellens, and H. M. Van Praag Efficacy and Safety of Fluoxetine in the Treatment of Patients With Major Depression After First Myocardial Infarction: Findings From a Double-Blind, Placebo-Controlled Trial Psychosom Med, December 1, 2000; 62(6): 783 - 789. [Abstract] [Full Text] [PDF]

				S. R. Ommen, R. A. Nishimura, C. P. Appleton, F. A. Miller, J. K. Oh, M. M. Redfield, and A. J. Tajik Clinical Utility of Doppler Echocardiography and Tissue Doppler Imaging in the Estimation of Left Ventricular Filling Pressures : A Comparative Simultaneous Doppler-Catheterization Study Circulation, October 10, 2000; 102(15): 1788 - 1794. [Abstract] [Full Text] [PDF]

				F. L. Dini, C. Michelassi, G. Micheli, and D. Rovai Prognostic value of pulmonary venous flow Doppler signal in left ventricular dysfunction: contribution of the difference in duration of pulmonary venous and mitral flow at atrial contraction J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1295 - 1302. [Abstract] [Full Text] [PDF]

				J. E. Moller, E. Sondergaard, J. B. Seward, C. P. Appleton, and K. Egstrup Ratio of left ventricular peak E-wave velocity to flow propagation velocity assessed by color M-mode Doppler echocardiography in first myocardial infarction: Prognostic and clinical implications J. Am. Coll. Cardiol., February 1, 2000; 35(2): 363 - 370. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, N. M. Lakkis, K. J. Middleton, D. Killip, W. A. Zoghbi, M. A. Quinones, and W. H. Spencer III Changes in left ventricular filling and left atrial function six months after nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1123 - 1128. [Abstract] [Full Text] [PDF]

				F. Gonzalez-Vilchez, M. Ares, J. Ayuela, and L. Alonso Combined use of pulsed and color M-mode doppler echocardiography for the estimation of pulmonary capillary wedge pressure: an empirical approach based on an analytical relation J. Am. Coll. Cardiol., August 1, 1999; 34(2): 515 - 523. [Abstract] [Full Text] [PDF]

				R. Willenheimer, B. Israelsson, C. Cline, E. Rydberg, K. Broms, and L. Erhardt Left atrioventricular plane displacement is related to both systolic and diastolic left ventricular performance in patients with chronic heart failure Eur. Heart J., April 2, 1999; 20(8): 612 - 618. [Abstract] [PDF]

				E.G. Torrecilla, M.A. Garcia Fernandez, H. Bueno, M. Moreno, and J.L. Delcan Pulmonary venous flow in hypertrophic cardiomyopathy as assessed by the transoesophageal approach: The additive value of pulmonary venous flow and left atrial size variables in estimating the mitral inflow pattern in hypertrophic cardiomyopathy Eur. Heart J., February 2, 1999; 20(4): 293 - 302. [Abstract] [PDF]

				A. Mesa, C. Jessurun, A. Hernandez, K. Adam, D. Brown, W. K. Vaughn, and S. Wilansky Left Ventricular Diastolic Function in Normal Human Pregnancy Circulation, February 2, 1999; 99(4): 511 - 517. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, N. M. Lakkis, K. J. Middleton, D. Killip, W. A. Zoghbi, M. A. Quinones, and W. H. Spencer Changes in Left Ventricular Diastolic Function 6 Months After Nonsurgical Septal Reduction Therapy for Hypertrophic Obstructive Cardiomyopathy Circulation, January 26, 1999; 99(3): 344 - 347. [Abstract] [Full Text] [PDF]

				S. F. Nagueh, N. M. Lakkis, K. J. Middleton, W. H. Spencer III, W. A. Zoghbi, and M. A. Quinones Doppler Estimation of Left Ventricular Filling Pressures in Patients With Hypertrophic Cardiomyopathy Circulation, January 19, 1999; 99(2): 254 - 261. [Abstract] [Full Text] [PDF]

				G. Hahalis, D. Alexopoulos, A. S. Manolis, M. Hamada, Y. Shigematsu, K. Hiwada, Y. Hara, S. Ikeda, H. Okayama, K. Kodama, et al. Altered Mitral Flow Pattern in Patients With Hypertrophic Obstructive Cardiomyopathy • Response Circulation, November 10, 1998; 98 (19): 2098 - 2102. [Full Text] [PDF]

				S. F. Nagueh, I. Mikati, H. A. Kopelen, K. J. Middleton, M. A. Quinones, and W. A. Zoghbi Doppler Estimation of Left Ventricular Filling Pressure in Sinus Tachycardia : A New Application of Tissue Doppler Imaging Circulation, October 20, 1998; 98(16): 1644 - 1650. [Abstract] [Full Text] [PDF]

				G. D. Pennock, D. D. Yun, P. G. Agarwal, P. H. Spooner, and S. Goldman Echocardiographic changes after myocardial infarction in a model of left ventricular diastolic dysfunction Am J Physiol Heart Circ Physiol, October 1, 1997; 273(4): H2018 - H2029. [Abstract] [Full Text] [PDF]

				G. M. Scalia, N. L. Greenberg, P. M. McCarthy, J. D. Thomas, and P. M. Vandervoort Noninvasive Assessment of the Ventricular Relaxation Time Constant ({tau}) in Humans by Doppler Echocardiography Circulation, January 7, 1997; 95(1): 151 - 155. [Abstract] [Full Text]

				S. F. Nagueh, H. A. Kopelen, and M. A. Quinones Assessment of Left Ventricular Filling Pressures by Doppler in the Presence of Atrial Fibrillation Circulation, November 1, 1996; 94(9): 2138 - 2145. [Abstract] [Full Text]

				S. F. Nagueh, H. A. Kopelen, and W. A. Zoghbi Relation of Mean Right Atrial Pressure to Echocardiographic and Doppler Parameters of Right Atrial and Right Ventricular Function Circulation, March 15, 1996; 93(6): 1160 - 1169. [Abstract] [Full Text]

				R. S. Vasan, E. J. Benjamin, and D. Levy Congestive Heart Failure With Normal Left Ventricular Systolic Function: Clinical Approaches to the Diagnosis and Treatment of Diastolic Heart Failure Arch Intern Med, January 22, 1996; 156(2): 146 - 157. [Abstract] [PDF]